Getting it Together After the Diagnosis: Making a Plan With Your Partner

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When my doctor first used the term “infertility”, I wasn’t sure what to make of the diagnosis. I was only 28 years old and my diminished ovarian reserve made something that was already going to be difficult — starting a family as a same-sex couple — sound more and more improbable. Since my wife has uterine fibroids, she wasn’t the perfect candidate either, but doctors insisted if I ever wanted to conceive, now was the time.

Initially, I wasn’t sure how to unpack all of the information that was thrown at us. There were numbers, percentages, the doctor urging, “Don’t delay, act now”, but my wife and I simply weren’t ready to be parents. As we discussed our options, there were heated arguments, moments of embrace, and the occasional soothing optimism. What was best for us, we decided, was not to “act now”, but to “act thoughtfully”, and to put in place a timeline and budget so we could have the family we wanted, without mortgaging our happiness.

Fertility treatment can feel overwhelming and frantic. We want answers. We need a timeline. We want a guarantee that there will be a baby born at the end of this. Unfortunately for individuals and couples undergoing fertility treatment, the entire process is a roll of the dice, and for those of us who are not gamblers, decision-making can feel impossible.

Sam and I learned a lot of lessons in undergoing various treatments, at multiple clinics, over the years. We’ve emerged closer than ever, and sitting here at eight months pregnant, I can look back and acknowledge that there are a few things we got really right, and a few things I wish we could do over. Here are a few that stick with me, many months later.

Get on the phone with your insurer immediately

It’s important to go into fertility treatments knowing what is, and is not, covered. Are you covered for IUI or IVF? Will your provider cover the cost of fertility medications? Getting these answers will help you and your doctor decide the best course of action. If your insurance company, for instance, will cover the cost of IUI, but not IVF, then your doctor might be willing to try this method for a longer period of time before moving onto a more aggressive option.

As a woman in a same-sex marriage, I was faced with a lot of uncertainty when dealing with my insurance company. Like many insurance providers, mine had no definition of infertility for same-sex couples, and in hindsight, I should have spent more time researching — and potentially switching insurance providers — to find a plan with which I felt effectively covered. Had I switched sooner, I likely would have had my IUIs covered, and once those failed, possibly some of my medication for IVF treatment. Instead, I’ve paid for nearly all of it out of pocket, many thousands of dollars in aggregate.

Put in the hours to decide on a doctor

Fertility doctors and clinics differ dramatically, and so you need to familiarize yourself with what’s out there, and what truly matters to you as a patient. You might want a doctor who has the highest success rate, even if that means she never has enough time to answer all of your questions. Maybe you prefer a doctor who spends time with you and is available when you need him. When we started our journey, we preferred the latter over the former, but as our prospects changed, so did our priorities. When it came time to make a change, we knew what was out there, and we acted decisively. It proved to be the right call.

One thing that gets overlooked is that fertility treatment means spending a lot of time at the doctor’s office. Convenience and location may seem like puzzling criteria for something so important, but this is a delicate process, and missed appointments add needless stress, which can compromise your chances of success.

Maybe this means deciding beforehand how many rounds of IVF you’re prepared to undergo, or whether or not you’re comfortable taking fertility medication. The “how far are we willing to go” talk was an important one for my wife and me, and after many conversations, we found a sperm donor ($800 per vial), underwent IUI ($1,000 - $2,500) and then eventually IVF ($15,000 - $25,000), feeling completely united. This kind of support is vital when you’re not only spending thousands of dollars but also preparing to put a lot of emotional and physical stress on your body or bodies.

Clear your schedule

Okay, you don’t have to clear it, but fertility treatments are going to take up a lot of your time and most of your headspace, so if possible, dial it back on your calendar. Marathon training might have to wait until next year, and vacations may need to be postponed. The more time you have to focus on your wellness, the better. Once I began nightly IVF injections, for instance, Sam and I knew we needed to be home every evening around the same time for weeks to come, which meant fewer after work commitments and dinners out with friends. I also needed Sam to help me with injections, which meant she couldn’t travel for work. Fertility monitoring often takes place early in the morning and clinics are notoriously late, so if possible, adjust your schedule accordingly.

Stick together

Sam and I realized early on that we needed to be united in our quest for motherhood. If you’re going to welcome a healthy baby into a healthy home, then both you and your partner need to nourish your relationship and yourselves. It didn’t always come easily, but Sam and I tried to communicate openly every step of the way. This meant actually listening to each other, and respecting each other’s wishes and concerns. Even if you don’t initially agree on some aspects of your fertility journey, I suggest keeping an open mind and an open heart and valuing that this will not simply be your individual child or your individual future, but the one you’ve created together, in unity. As with parenthood, there’s really no right way to prepare for fertility treatment. Give yourself and your partner some extra TLC as you enter into this phase of your life. Stick together and no matter the outcome, you won’t have to feel alone in any of this.